(April 2004) In developing countries, millions of people suffer from avoidable health problems—such as infectious diseases, malnutrition, and complications of childbirth—simply because they are poor. Wide differences in health status between poorer and better-off people are often avoidable and unfair, reflecting different socioeconomic constraints and opportunities rather than different individual choices. And while governments have made strides in improving public health over the last several decades, many initiatives to improve the health of the poorest people have been unsuccessful. In recent years, new research has become available on health inequalities in developing countries. These studies shed light on how the world’s poorest people are faring, demonstrating for the most part how persistent and pervasive health inequalities are. Other research has assessed a variety of approaches to reducing health inequalities, including reforms in the way health care is financed and organized, improvements in the quality and accessibility of services, and broader community development.

This policy brief, based on a longer report by the Population Reference Bureau, highlights the extent of the rich-poor health divide, the factors that play a role in health disparities, and approaches for improving the health of the poor.